Opportunity History

***PLEASE SEE ATTACHMENT FOR FULL RFI INFORMATION***1.0 Purpose of this RFIThe Defense Health Agency (DHA)/Defense Health Cost Assessment and Evaluation (DHCAPE) is issuing this Request for Information (RFI) as a means of conducting market research to make appropriate acquisition decisions and to gain knowledge of potential qualified vendors interested and capable of performing the work.DHCAPE is seeking information from companies who have the capability and experience to provide services to complete high volume, complex data analysis, statistical/data modeling, forecasting, data extraction, data maintenance, data validation, and data quality tasks for the Military Health Systems, including both Purchased Care and Direct Care health records. The tasks are of a higher order complexity requiring knowledge, skills and abilities in military health care.

2.0 BackgroundDHA, a Combat Support Agency, supports the delivery of integrated, high quality health services to beneficiaries of the Military Health System (MHS), and executes responsibility for shared services, functions, and activities in support of the Military Services. The DHA serves as program manager for the TRICARE military health program.DHCAPE supports performance-based decision making for DHA by applying appropriate scientific methods and operational support. DHCAPE uses a multidisciplinary approach to investigate complex issues in measuring, evaluating and analyzing the performance of healthcare delivery systems and developing innovative methods for providing high quality health care to over 9.7 million beneficiaries, worldwide, and extends from theater medical care for deployed forces to peacetime healthcare supporting active duty, family members, Guard and Reserves, former spouses, foreign nationals, et al. Under this RFI, the vendor should access and query both Military Health System (MHS) and external data sources to ensure data quality in the MDR, M2, and other reference data sources; train the MHS in the availability and proper use of these reference data sources; and provide oversight, support, and technical expertise to DHA coding workgroups and the various functions.

3.0 Information Requested This RFI is being used to collect information about capability of qualified vendors to access and query both the MHS and external data sources to provide the following support services: • Various oversight and/or support activities involving the MHS Data Repository (MDR) and the MHS Management Analysis and Reporting Tool (M2) data systems. For example, support may include responding to and resolving data quality issues, conducting analysis, and supporting data types within the MDR and M2 and the Tricare Encounter Data (TED) operational data store. • Assistance on management of MHS reference files, derived data elements, and code sets for the TED and Patient Encounter Processing and Reporting (PEPR) systems, and functional requirements for the MHS downloads for purchase care extracts. Examples include monitoring, downloading and assisting with updates of TED and PEPR Reference Tables. • Subject Matter Expert (SME) training support for the enterprise and various workgroups on the MDR/M2 data base system. Prior examples include providing Working Information Systems to Determine Optimal Management (WISDOM) education support and answering questions from data analysts regarding various queries. • SME support for maintaining TED/PEPR derived data elements, MDR/M2 specifications and dictionary.• Analyses of Military versus private/public healthcare delivery standards and practices to identify and recommend improved military healthcare metrics and best business practices and plans. Activities include, but are not limited to, population analysis, program analysis, business case analysis, and modeling for existing, new or proposed programs, benefits, or demonstrations. • Coding subject matter expert activities which may include pulling data; assessing coding issues/risks; providing expertise to various coding workgroups such as the Unified Biostatistical Utility/Uniform Business Office (UBU/UBO), or Uniform Coding Workgroup (UCW) regarding coding activities; and assisting the DHA in submitting coding additions and changes to the standard bodies such as CMS, AMA, ADA, etc., for ICD, CDT, CPT/HCPCS, HIPAA taxonomy, etc.• Updates to the DHCAPE web site. Activities include processing and posting MDR/M2 specification documents, processing data dictionaries monthly, assisting the web team resolve ongoing website needs; and ensuring the website meets 508 compliance standards.• Analysis and Administrative activities. Analytic and administrative activities may consists of data extraction; creating reports; scheduling & facilitating meetings; emailing/phone communications; maintaining official & draft documents; and preparing presentations.• Functional Proponent Support, Data and Analysis Support (population forecasting, data modeling)• Programming and analytic support for identification and evaluation of improper and/or excessive purchased care payments.• Routine calculation and analysis to support MHS financial statements.